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State-Specific Disclosures - United Concordia Dental

State-Specific Disclosures & Information

Civil Union Notice – Residents of Delaware

The Delaware Civil Union and Equality Act of 2011 created a legal relationship between two persons of the same or opposite sex who form a civil union, as of January 1, 2012. It also provides that parties to a civil union are entitled to the same legal obligations, responsibilities, protections and benefits as those afforded or recognized by the laws of Delaware to spouses in a legal marriage. The Act also provides that a party to a civil union shall be included in any definition or use of the terms “marriage,” “married,” “spouse,” “family,” “immediate family,” “dependent,” “next of kin” or any other descriptive term for a spousal relationship when used in Delaware law including the Delaware Insurance Code.

Effective January 1, 2012, under all United Concordia insurance plans covering Delaware residents, any benefit, coverage or right, governed by Delaware state law that is provided to a person considered a spouse by marriage will also be provided to a party to a civil union and any benefit, coverage or right governed by Delaware state law, provided to a child of a marriage will also be provided to a child of a civil union.

Federal law may impact how certain spousal rights and benefits within some insurance products are treated. For example, federal tax laws that afford favorable income-deferral options to an opposite-sex spouse under the Internal Revenue Code do not currently extend such rights to a same-sex spouse (e.g., the Federal Defense of Marriage Act).

For more information on the act or how it affects your insurance coverage, contact United Concordia by using the telephone number listed on your ID card.

 

Claim information for dependents with disabilities – Residents of Delaware

If you are a resident of Delaware and have an enrolled Dependent with severe disabilities, the dependent may receive coverage for services from a non-network dentist at the same level as if the covered services were provided by a network dentist. In this instance, a non-network dentist is prohibited from balance billing you for the difference between the provider’s full charge and the payment received for covered services by state law.

 

Insurer requirements for claim denials – Residents of Arizona, California, Maryland, Michigan, New Jersey, New York and Rhode Island

Please note: In Arizona, California, Maryland, Michigan, New Jersey, New York and Rhode Island, state law requires additional information to be requested prior to denial, if additional information might lead to claim approval.

 

Return policy for Medicare recipients – Residents of North Carolina and New Jersey

In North Carolina and New Jersey, if you are eligible for medicare by reason of age, you have 30 days to review and return an iDental individual dental insurance policy should you choose to do so.

 

State-Specific Exceptions – Residents of CO, CT, DE, IL, IN, LA, MD, NC, OK, TX and VT

Colorado: Civil Union spouses are covered.

Connecticut: Civil Union spouses are covered for civil unions in effect prior to 10/1/10. Thereafter, the definition of spouse encompasses spouses of same-sex and opposite-sex marriages.

Delaware: The Delaware Civil Union and Equality Act of 2011 created a legal relationship between two persons of the same or opposite sex who form a civil union, as of January 1, 2012. It also provides that parties to a civil union are entitled to the same legal obligations, responsibilities, protections and benefits as those afforded or recognized by the laws of Delaware to spouses in a legal marriage. The Act also provides that a party to a civil union shall be included in any definition or use of the terms “marriage,” “married,” “spouse,” “family,” “immediate family,” “dependent,” “next of kin” or any other descriptive term for a spousal relationship when used in Delaware law including the Delaware Insurance Code.Illinois: Eligible dependents (unmarried natural children, stepchildren, or adopted or placed children) are covered until age 30.

Effective January 1, 2012, under all United Concordia insurance plans covering Delaware residents, any benefit, coverage or right, governed by Delaware state law that is provided to a person considered a spouse by marriage will also be provided to a party to a civil union and any benefit, coverage or right governed by Delaware state law, provided to a child of a marriage will also be provided to a child of a civil union.

Federal law may impact how certain spousal rights and benefits within some insurance products are treated. For example, federal tax laws that afford favorable income-deferral options to an opposite-sex spouse under the Internal Revenue Code do not currently extend such rights to a same-sex spouse (e.g., the Federal Defense of Marriage Act).

For more information on the act or how it affects your insurance coverage, contact United Concordia by using the telephone number listed on your ID card.

Indiana: In addition to the dependents listed, a grandchild or other blood relative who is financially dependent on the insured for 50% or more of his/her total support.

Louisiana: Grandchildren in the Policyholder’s legal custody and unmarried children placed in the Policyholder's home pursuant to LA Civil Code, following execution of an act of voluntary surrender, are also eligible.

Maryland: In addition to the dependents listed, grandchildren are also eligible.

North Carolina: Foster children are included in the definition of dependent and are eligible upon placement in a foster home or automatically from birth for 30 days if the foster child is a newborn.

Oklahoma: A child in a Policyholder’s legal custody pursuant to an interlocutory decree prior to adoption regardless of whether the final order granting adoption is ultimately issued.

Pennsylvania: In addition to the dependents listed, any newborn child of an insured person from the moment of birth is considered to be a dependent.

Texas: In addition to the dependents listed, unmarried grandchildren are also eligible.

Vermont: Same-sex spouses of Civil Unions are covered if the Civil Union occurred prior to 9/1/09. Thereafter, the definition of spouse encompasses spouses of same-sex and opposite-sex marriages.

 

VA MCHIP Statement – Residents of Virginia

In accordance with 12 VAC 5-408-230 (L), Virginia MCHIP covered persons, providers, and employers may request a copy of United Concordia’s Annual Performance Results by contacting:

United Concordia Companies, Inc.
Customer Service Department
P.O. Box 69420
Harrisburg, PA 17106-9420